脊柱枪伤：是否应取出残留子弹以预防感染？
Gunshot wounds of the spine: should retained bullets be removed to prevent infection?
作者信息
Velmahos G, Demetriades D
机构信息
Department of Surgery, Baragwanath Hospital, Johannesburg, South Africa.
出版信息
Ann R Coll Surg Engl. 1994 Mar;76(2):85-7.
We have investigated the role of retained bullets and other possible risk factors in the development of local septic complications after gunshot wounds (GSW) of the spine. Of 153 patients with GSW of the spine followed up for a mean of 28 months, the overall incidence of bullet wound related septic complications was 9.8%. In 81 patients the bullet was retained and the incidence of local septic complications was 7.4%. In 72 patients the bullet left the body (70) or was removed on admission (2), and the sepsis rate was 12.5% (P > 0.05). In 24 patients there was an associated colonic injury and the incidence of sepsis was 8.4% compared with 5% in the group of patients with intra-abdominal injuries but no colonic trauma (P > 0.05). The incidence of septic complications in lumbar spine injuries was significantly higher than in thoracic and cervical spine injuries (P > 0.05). We believe that in GSW of the spine, retained bullets do not increase the likelihood of septic complications.
我们研究了脊柱枪伤（GSW）后留存子弹及其他可能的风险因素在局部感染并发症发生过程中的作用。在153例脊柱枪伤患者中，平均随访28个月，与枪伤相关的感染并发症总发生率为9.8%。81例患者子弹留存，局部感染并发症发生率为7.4%。72例患者子弹穿出体外（70例）或入院时取出（2例），败血症发生率为12.5%（P>0.05）。24例患者伴有结肠损伤，败血症发生率为8.4%，而腹部损伤但无结肠创伤患者组的发生率为5%（P>0.05）。腰椎损伤患者感染并发症的发生率显著高于胸椎和颈椎损伤患者（P>0.05）。我们认为，在脊柱枪伤中，留存子弹不会增加感染并发症的可能性。
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